Every day I experience life in the world of healthcare IT, supporting 3000 doctors, 18000 faculty, and 3 million patients. In this blog I record my experiences with infrastructure, applications, policies, management, and governance as well as muse on such topics such as reducing our carbon footprint, standardizing data in healthcare, and living life to its fullest.

Tuesday, August 5, 2008

The iPhone is what I want, the Blackberry is what I need

I've been a Blackberry advocate in the past, so immediately my objectivity analyzing the new iPhone 3G will be called into question.

If it helps, I have an entirely Apple household - a Macbook Air, a Macbook Pro, an iMac 20, and 3 iPod Nano's. All my blogs are published from my Macbook Air via Firefox. I truly attempt to be Geneva in my testing of every technology.

For the past week, I've been running an iPhone 3G in parallel with my Blackberry Curve. I've tested its integration with Exchange email, its network support on 3G/2.5G/WiFi, its battery life, its App Store, and its user interface.

There are many aspects of the iPhone which are truly innovative and work extremely well. There are other aspects which I found frustrating, such as the touch screen keyboard and the short battery life. Whether or not the iPhone is the perfect mobile device for you depends on your use case for needing mobility.

Here's the detail of my experiences.

AT&T provided me an iPhone for testing including an account with a generous voice and data plan. The first step was to activate the phone. We ran into several difficulties that were unrelated to the iPhone itself - AT&T had mistakenly associated the iPhone account with the personal account of a faculty member who had a past due balance. Thus, they refused to activate the iPhone until this other person's balance was paid. Several phone calls and emails later, the issue was resolved. We were then able to activate the account. It's interesting that account activation requires the iPhone to be directly connected to iTunes via USB. For folks who have not used iTunes previously, the notion of a phone with a dependency on music management software will be a bit of learning curve.

Once the phone was activated, my next step was to integrate it with Microsoft Exchange. The Apple engineering to integrate the iPhone into enterprise Exchange environments via Active Sync is top notch. The problem that I ran into was a usability problem, which surprised me, since Apple is so good with usability.

To integrate the iPhone into Exchange, you need to type your email address, domain\username, password, and server name. Typing on the iPhone requires the use of a touch screen keyboard, because there are no true keys on the device. The first screen of the keyboard contains only the letters A-Z without punctuation, symbols or numbers. Pressing the .?123 key produces the numbers 0-9, a forward slash, punctuation and a few symbols. On this screen is a mysterious key labeled "#+=". Pressing it produces many commonly needed keys including the backslash. I think you can see where this is going.

I typed in my email address, then had to type in my domain\username. Since I could not find the backslash, I assumed that the iPhone required me to use a forward slash. I entered my password (which is alphanumeric, mixed case and a non-English word requiring me to toggle through 3 keyboard screens multiple times), and server name. Then the truly odd behavior began.

For whatever reason, the iPhone's calendar can sync with Exchange when the domain\username has a forward slash instead of a backslash, but email does not work. Even worse, since Active Sync perceives there is something wrong with the username/password, it keeps retrying and locks Active Directory. I sat with our server administrators and unlocked my Active Directory account numerous times as we tried various combinations of username/password entries. I finally thought to try a backslash instead of forward slash in my username, discovered the appropriate key and got everything working. Once I did, the push email through Active Sync was very impressive, delivering calendars, contacts and email with a speed that is very similar to the Blackberry.

I then began to reply to email and that's where my next adventure started. I had to type a medical consult in response to a Poison Control query about a mushroom ingestion. I typed

"The patient will be fine"

which appeared as

"The patient will be gone"

Why?

The iPhone keyboard is a touch screen with small non-tactile keys. A tall adult male with large hands (me) is going to "fat finger" the keys, so Apple has implemented a T9 like system to predict what words you meant to type. The F and G are next to each other as are the I and O on a QWERTY keyboard. FINE and GONE are valid combinations of pressing F/G and I/O with a fat finger.

Then I wrote

"The patient will live for a good long time"

which appeared as

"The patient will lice for a food long time"

I've spend days working with the touch screen keyboard and the although I'm modestly improved, the non-tactile T9 driven keyboard is just not as fast as the Blackberry keyboard.

On average, email takes me 3 times longer on the iPhone keyboard than on a Blackberry, assuming I want perfectly correct messages. The extra time is spent using the backspace key to correct those words that were fat fingered or T9'ed into some truly amusing typos i.e.

"The Lord is my Shepherd, I shall not want"

became

"The Lord is my Shepherd, I shall NPR want"

and

"The quick brown fox jumped over the lazy dogs"

became

"The quick brown fox jumped OCR the lazy dogs"

I'm sure the dogs enjoyed the Optical Character Recognition.

Just to be sure that my experiences were not the product of my unhip 46 year old email centric worklife, I spoke with several twentysomethings about their experiences with the iPhone. They all confirmed that they spend a great deal of time reviewing any professional email they send. Their consistent comment to me was that the iPhone is a great consumer device and a problematic corporate device.

So, the bottom line is that the iPhone is a great web browser, a great application platform, and a great way to read email. The App Store enables a new kind of commerce - the micro-app, truly democratizing application distribution in the way that Web 2.0 democratized publishing. BTW - the phone works well too.

However, the iPhone is not a perfect email appliance for someone who has to answer hundreds of emails each day with total accuracy.

Thus, if you want a truly innovative mobile computer for consumers that manages multimedia, has hundreds of add on applications through the App Store, and that connects to WiFi and 3G networks (note, these result in a battery life of a few hours at best), then you want an iPhone.

If an email appliance is your use case for mobility, you need a Blackberry.

I will watch the evolution of the iPhone very closely. If the keyboard issue is resolved, then Blackberry will have true competition among corporate email users. Until then, the device on my belt will be a Blackberry.

18 comments:

With mobile photography technologies becoming more robust and the trend towards tighter interoperability among systems, do you see promise for technologies like www.clickdiagnostics.com. They won in the MIT 100K competition Development Track.

Currently, it has direct application in third world countries but do you see a future for targeted use in the U.S. or have any thoughts on mobile diagnostics.

I've been an iPhone user as a physician for almost a year now. It really is a great device and it does take some time to get used to the keyboard. I typed your examples into the Notes app with zero errors at a reasonable speed and let the auto-correct work.

All I can say is give yourself some time to get used to the virtual keyboard, after all you've been using the Blackberry keyboard for years.

Thanks for your great review of the iPhone. I got mine the day it came out, and, although, it is currently still plagued by bugs, I can't imagine going back to my old Windows PDA/phone.

A program called iChart (www.caretools.com) was just released for the iPhone which allows doctors to write progress notes, order meds to local drug stores, and access and review lab values, and, most importantly, constantly syncs all changes with the server. I'm sure you have heard about this program and was just wondering your take on it.

A relatively easy fix on Apple's part would be to allow you to turn the phone sideways and type, similar to how you can when typing web addresses in Safari. The keyboard is much larger and I am faster and more accurate compared to trying to answer emails. But without the tactile keyboard and removable battery I don't see how it could replace the Blackberry for enterprise use. But it would be a welcome addition for sure especially for consumers who are on the edge of needing a Blackberry.

I'm going to be the one disenting voice -- the new Blackberry Bold has some serious multipmedia management tools. I think it's iPhone that needs to look out on the consumer side not RIM on the enterprise. Good review John. Thx.

You *can* turn the iPhone sideways and type on a larger keyboard. I recommend that you sit down with someone who's mastered typing on the iPhone to learn some of the truly innovative ways to input text. FYI- you should rarely be hitting backspace.

Also, your comparison to T9 is far off base. T9 works out the most likely word you're trying to spell given the letters associated with the numbers you've pressed. Since you're not pressing numbers on the iPhone, there's no comparison. While the iPhone's corrections are very annoying at first, it *will* learn to work with your input quirks.

I hope you're quietly still playing around with your iPhone. The mobile browsing experience it offers is light-years ahead of anything else and your text input rate will improve with usage.

I have been saying this for over 15 years -- For work, the Mac is what I want; the PC is what I need. Same for the iPhone -- For work, the iPhone is what I want, the Blackberry is what I need.

On the other hand, as painful the learning curve will be to use the iPhone's touch / virtual keyboard, I'm gearing up for it. This is because this is where keyboard / mouse technology is headed ..... (with even Microsoft intending to include touch technology in its next OS).

It's seemed to get better for me (a 47 year old tall male with fingers apparently just as fat as yours :-) as time passes, but I admit I still review my iPhone emails more carefully before I send them than the ones I send with a computer. Having never used a Blackberry, I can't compare.

I have used the sideways keyboard with web apps. What a difference! I fat finger much less, because the keys are both bigger and further apart.

I suspect that I'll be handed a Blackberry if/when I move to a more corporate environment. And I'll like it just fine-and it'll be optimized for the corporate environment. The iPhone is not optimized-yet.

John,It took me a few days, and I have noticeably improved. I make the same # of typos, except now they show up as other words instead of mispelled ones. I will note that I find that the extra time spent looking at the email to be slightly beneficial. I find most BB written mail to be a tad rushed.

Also walking down the hall, using the new portal, pulling up OMR and POE (our EHR/CPOE applications), albeit a tad clumsy to zoom/unzoom, was pretty cool...

Thanks for all the comments folks. I'm back from vacation. As an organization we'll embrace the iPhone and ensure it is supported for all users with the same service levels as the Blackberry. I'll keep trying to master my iPhone typing skills. If the email app could offer a keyboard in landscape mode, I'm sure my typing would improve.

I have enjoyed the debate on iPhone vs. BlackBerry. I am just entering the healthcare IT space and realized that the security of information is the number 1 priority of much of the electronic communication in healthcare.

I have heard that the encryption and security on the iPhone is not as robust as on the BlackBerry. Do you have information on this? We are developing applications for use on the BlackBerry in healthcare settings and it is the first question that often comes up.